Accuracy of online symptom checkers and the potential impact on service utilisation.

<h4>Objectives</h4>The aims of our study are firstly to investigate the diagnostic and triage performance of symptom checkers, secondly to assess their potential impact on healthcare utilisation and thirdly to investigate for variation in performance between systems.<h4>Setting<...

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Autores principales:	Adam Ceney, Stephanie Tolond, Andrzej Glowinski, Ben Marks, Simon Swift, Tom Palser
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/b2fae1df26a14587b6ef90670487a4e1
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spelling	oai:doaj.org-article:b2fae1df26a14587b6ef90670487a4e12021-12-02T20:06:57ZAccuracy of online symptom checkers and the potential impact on service utilisation.1932-620310.1371/journal.pone.0254088https://doaj.org/article/b2fae1df26a14587b6ef90670487a4e12021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0254088https://doaj.org/toc/1932-6203<h4>Objectives</h4>The aims of our study are firstly to investigate the diagnostic and triage performance of symptom checkers, secondly to assess their potential impact on healthcare utilisation and thirdly to investigate for variation in performance between systems.<h4>Setting</h4>Publicly available symptom checkers for patient use.<h4>Participants</h4>Publicly available symptom-checkers were identified. A standardised set of 50 clinical vignettes were developed and systematically run through each system by a non-clinical researcher.<h4>Primary and secondary outcome measures</h4>System accuracy was assessed by measuring the percentage of times the correct diagnosis was a) listed first, b) within the top five diagnoses listed and c) listed at all. The safety of the disposition advice was assessed by comparing it with national guidelines for each vignette.<h4>Results</h4>Twelve tools were identified and included. Mean diagnostic accuracy of the systems was poor, with the correct diagnosis being present in the top five diagnoses on 51.0% (Range 22.2 to 84.0%). Safety of disposition advice decreased with condition urgency (being 71.8% for emergency cases vs 87.3% for non-urgent cases). 51.0% of systems suggested additional resource utilisation above that recommended by national guidelines (range 18.0% to 61.2%). Both diagnostic accuracy and appropriate resource recommendation varied substantially between systems.<h4>Conclusions</h4>There is wide variation in performance between available symptom checkers and overall performance is significantly below what would be accepted in any other medical field, though some do achieve a good level of accuracy and safety of disposition. External validation and regulation are urgently required to ensure these public facing tools are safe.Adam CeneyStephanie TolondAndrzej GlowinskiBen MarksSimon SwiftTom PalserPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 7, p e0254088 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Adam Ceney Stephanie Tolond Andrzej Glowinski Ben Marks Simon Swift Tom Palser Accuracy of online symptom checkers and the potential impact on service utilisation.
description	<h4>Objectives</h4>The aims of our study are firstly to investigate the diagnostic and triage performance of symptom checkers, secondly to assess their potential impact on healthcare utilisation and thirdly to investigate for variation in performance between systems.<h4>Setting</h4>Publicly available symptom checkers for patient use.<h4>Participants</h4>Publicly available symptom-checkers were identified. A standardised set of 50 clinical vignettes were developed and systematically run through each system by a non-clinical researcher.<h4>Primary and secondary outcome measures</h4>System accuracy was assessed by measuring the percentage of times the correct diagnosis was a) listed first, b) within the top five diagnoses listed and c) listed at all. The safety of the disposition advice was assessed by comparing it with national guidelines for each vignette.<h4>Results</h4>Twelve tools were identified and included. Mean diagnostic accuracy of the systems was poor, with the correct diagnosis being present in the top five diagnoses on 51.0% (Range 22.2 to 84.0%). Safety of disposition advice decreased with condition urgency (being 71.8% for emergency cases vs 87.3% for non-urgent cases). 51.0% of systems suggested additional resource utilisation above that recommended by national guidelines (range 18.0% to 61.2%). Both diagnostic accuracy and appropriate resource recommendation varied substantially between systems.<h4>Conclusions</h4>There is wide variation in performance between available symptom checkers and overall performance is significantly below what would be accepted in any other medical field, though some do achieve a good level of accuracy and safety of disposition. External validation and regulation are urgently required to ensure these public facing tools are safe.
format	article
author	Adam Ceney Stephanie Tolond Andrzej Glowinski Ben Marks Simon Swift Tom Palser
author_facet	Adam Ceney Stephanie Tolond Andrzej Glowinski Ben Marks Simon Swift Tom Palser
author_sort	Adam Ceney
title	Accuracy of online symptom checkers and the potential impact on service utilisation.
title_short	Accuracy of online symptom checkers and the potential impact on service utilisation.
title_full	Accuracy of online symptom checkers and the potential impact on service utilisation.
title_fullStr	Accuracy of online symptom checkers and the potential impact on service utilisation.
title_full_unstemmed	Accuracy of online symptom checkers and the potential impact on service utilisation.
title_sort	accuracy of online symptom checkers and the potential impact on service utilisation.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/b2fae1df26a14587b6ef90670487a4e1
work_keys_str_mv	AT adamceney accuracyofonlinesymptomcheckersandthepotentialimpactonserviceutilisation AT stephanietolond accuracyofonlinesymptomcheckersandthepotentialimpactonserviceutilisation AT andrzejglowinski accuracyofonlinesymptomcheckersandthepotentialimpactonserviceutilisation AT benmarks accuracyofonlinesymptomcheckersandthepotentialimpactonserviceutilisation AT simonswift accuracyofonlinesymptomcheckersandthepotentialimpactonserviceutilisation AT tompalser accuracyofonlinesymptomcheckersandthepotentialimpactonserviceutilisation
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Accuracy of online symptom checkers and the potential impact on service utilisation.

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